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脓毒症是重症监护室患儿死亡的重要原因之一,尽管抗感染和积极对症处理是治疗的关键,但是否能获得合理而有效的营养支持也是影响其临床预后的重要因素。脓毒症患儿处于应激状态,营养支持需在不增加脏器负担的基础下尽可能满足对能量和蛋白质等营养素的需求。尽管肠道功能常因全身感染的影响而受损,但营养支持方式仍应积极创造条件以首选肠内营养(EN),若EN无法满足,可给予补充性肠外营养(PN)。在营养支持过程中,可添加免疫营养素以调整患儿免疫功能、减轻炎症反应。
Sepsis is one of the most important causes of death in pediatric intensive care unit. Although anti-infective and aggressive symptomatic treatment are the keys to treatment, whether rational and effective nutritional support can be obtained is also an important factor affecting clinical prognosis. Children with sepsis are under stress and nutritional support needs to meet as much energy and protein nutrients as possible without increasing the organ burden. Although bowel function is often impaired by the systemic infection, nutritional support should be actively created to favor enteral nutrition (EN) and supplemental parenteral nutrition (PN) if EN can not be met. In the process of nutritional support, you can add immune nutrients to adjust the immune function in children to reduce the inflammatory response.